“He is such a nice, caring man. He couldn’t do such a thing,” *Ritesh’s teacher told him. She was the first person in whom he confided about the sexual abuse he was facing at the hands of his school principal. He was nine at the time.
The abuse continued for six long, excruciating years. Once his abuser had hit him hard. “My ear and nose started bleeding. I lost hearing in my right ear after the incident,” recalls Ritesh, who is 46 years old now.
The doctor noticed the marks on his body and tried enquiring. “But I didn’t have the words to articulate it, although the doctor encouraged me to confide in someone,” he says.
The next time Ritesh told someone – a school trustee – he received a positive response. The principal was removed from the school in 1987. The new headmistress was aware of what had happened to Ritesh. She made him write his ordeal on a piece of paper and burn it, expecting the act to shut the door on his emotional and psychological trauma.
After his abuser left, Ritesh finally mustered the courage to tell his parents about the sexual assault. “They told me that it doesn’t happen to boys, that I had a vivid imagination and so was making it all up. They also said that I was hanging out with the wrong company. They dismissed me, asking me to get back to studies, that it’s something I should not be talking about and what will people think,” recalls Ritesh.
“I still don’t have closure,” Ritesh says, with resignation. “There’s a physical pain to the sadness associated with being let down which I feel even today,” says Ritesh, who gradually started developing anxiety and depression as a result.
Child sexual abuse (CSA) has long-lasting and far-reaching consequences on the victims. But what exacerbates the repercussions for the child victims or adult survivors is not being believed, being dismissed or hushed by their loved ones, which could be non-abusive parent(s), relatives, teachers or other caregivers. This is secondary trauma.
Studies have found that victims disclose interpersonal violence, including CSA, “to obtain help, support, or understanding”, and when these needs are not met, it has a detrimental impact on their mental health and personal relationships.
In India, in 95% of the CSA cases reported, the abuser is someone known to the victim. Many don’t disclose it until they become adults, and many who disclose it are not believed.
When met with disbelief and denial
Ritesh’s grew up feeling uncomfortable with any physical touch. He struggled with alcohol abuse, self-harm, and night terrors. He grappled with mental health issues too, which led to him attempting suicide more than once.
“The first level of betrayal happens when the abuse occurs - especially when the abuser is someone known or a family member. This is because children are generally dependent on adults for protection and care. Therefore, dismissal, disbelief, silencing the child or partially blaming them for the abuse is another betrayal of trust,” points out Sheila Ramaswamy, Project Coordinator, Community Child and Adolescent Mental Health Service Project, Department of Child and Adolescent Psychiatry at NIMHANS, Bengaluru.
Children are then left with a lot of fear and confusion, making them vulnerable to mental health issues like anxiety and depression. Experiencing sexual abuse hampers their sense of personal boundaries in relationship contexts – especially in cases of familial abuse - due to confusions around sexual norms and appropriate ways to interact with people. This, in turn, affects the child’s future relationships - intimate partner as well as non-romantic ones, Sheila adds.
Alpana*, a 33-year-old Assam resident, was sexually abused by a distant uncle for six months when she was about 11. Finally, she disclosed it to her parents last year. “They just brushed it away saying it happens. That’s all they said, and I have been in a spiral since. I am depressed, anxious, suicidal and reckless,” she tells TNM.
Her uncle also groomed her – a preparatory process of gaining the child’s trust with the intent of abusing her/him, and manipulating the victim to keep the abuse a secret. “It wasn’t exactly my fault but I feel like I was an equal participant,” Alpana says bitterly.
With no help from her family in processing what happened to her, she now blames herself – a common repercussion of unacknowledged abuse.
“In such a scenario, their sense of worth can also be impacted, placing them more at risk for continued abuse,” explains Dr Divya Kannan, a Bengaluru-based clinical psychologist who specialises in trauma.
Even if non-abusive parents or caregivers do not entirely disbelieve the abuse after disclosure, an inadequate response may leave the victim feeling unsafe, even after years.
Chennai-based Navika* was sexually abused by a close family friend for two years when she was nine years old. She did not talk about it with her family until she got married. When she came down from abroad for her first delivery, she gave an ultimatum to her parents to not let the man visit the house as long as she and her newborn were there. “I felt less safe in that environment because I do not want to run into that person,” she adds.
With no response from her father, she ultimately stopped visiting him altogether.
Today, the relationship between the father and daughter is almost non-existent. Her father tries to communicate with Navika through her husband or sister.
“His response was the breaking point in our relationship. There’s no hatred or anger towards him, but I just respond to him like I would to another old person,” says Navika.
Long-term impact of unacknowledged trauma
In the absence of proper support or response, victims tend to lock away their trauma deep down in their minds.
For many, trauma may be internalised in ways that engenders poor self-esteem and dismal academic performance, among others. As the victim grows up, unresolved trauma can result in depression, which may manifest as substance abuse and suicidal behaviours.
As Dr Divya points out, a percentage of those impacted by CSA could develop post-traumatic stress disorder or PTSD (a mental health condition triggered by a traumatic event).
For Ritesh, his discomfort with touch seeped into his romantic relationships too. “When a former girlfriend and I would go out, she would want to hold my hand, but I was not comfortable. Even when I got married, I would avoid intimacy, using work as my alibi,” he recalls. His wife wasn’t aware of his childhood trauma then.
Alpana, on the other hand, is so traumatised, and has internalised the self-blame to such an extent that she does not want to have children. “I have read several reports that said that a sexual abuse victim could become an abuser too. I’m worried if I would turn out to be one. So, I deliberately keep away from small children,” she says.
A survivor may also externalise the secondary trauma by engaging in high risk behaviours, like unsafe sexual behaviour with multiple partners, among others.
Anuja Gupta, co-founder of Rahi Foundation, that focusses on women survivors of incest and child sexual abuse, explains why it is ideal to take action as soon as the abuse comes out.
“Even if the family believes the child, but no action has been taken, the child grows up living with the enormity of what happened to him/her. With limited psychological capacity at that age, the victim will find mechanisms to cope with the terrible reality,” she says.
Culture of silence
“Why don’t you take down that post? It’s not a good thing to be putting up. Your dad’s friends are on your friends’ list,” 28-year-old Vidhi’s mother told her, when she saw Vidhi’s Facebook post on how she was sexually abused by her father’s colleague when she was seven.
“Her first reaction was not, ‘why did you not tell us?’,” recalls Vidhi. “After all this time of healing, her reaction affected my mental health; took me back to feeling like a helpless seven-year-old.”
Alpana, meanwhile, believed her parents would at least support her when she finally shared her trauma and sought therapy. “But my father, who is also a doctor, was ashamed. He said that I do not need therapy. So, I stopped going,” she says.
Like Vidhi and Alpana, many child sexual abuse survivors become victims of the culture of cultivated silence around sex and sexual violence.
“How many parents, except a section of new generation ones, talk to their children about menstruation, wet dreams, or what to expect from a marital relationship in terms of intimacy. When positive and natural aspects of sex and sexuality are not spoken about, how are parents even going to start a conversation about sexual abuse?” asks Vidya Reddy, co-founder of Tulir, a Chennai-based centre for the prevention and healing of child sexual abuse. She adds that even if parents do talk about these topics, it’s only when cases of sexual violence are reported in the media.
According to Anuja, silence is like condoning the sexual abuse. “It may be easy to be silent about the abuse, but by that, the family member is taking the side of the perpetrator,” she says.
This is what Ritesh felt too. After his parents failed to believe him, he started distrusting them. “I thought that this man (abuser), and my parents were equal - one abused me, the other covered it up.”
Parents too may be distraught
Vidya, on the other hand, points out that caregivers may be “in a state of tumult” inside though they may be denying the abuse. It might be a complex topic to discuss for non-offending parents, too.
“Many parents will be distraught, and feel it is a reflection on themselves that the child was abused. When disclosure happens, many parents from the older generation believe that by downplaying the incident, they are wishing away the problem. They want their children to move on, without realising that forgetting something as visceral as the sexual abuse is not part of moving on,” says Vidya.
Divya adds, “Denial of abuse may serve as a way for adults to protect themselves, rather than the child.”
How caregivers should respond
Even if children are unable to disclose the abuse, there are signs that caregivers can pick up on. The most obvious indicators of sexual abuse are physical signs, such as genital injuries, physical marks and inexplicable urinary tract infections. Apart from these physical indicators, parents can also look out for emotional and behavioural indicators.
In younger children, this could manifest as bed-wetting, separation anxiety, constant crying and poor concentration, sudden drop in academic performance, and avoidance of a specific person(s), among others. In older children, it could be substance abuse, self-harm and runaway behaviour.
In Shubham’s case for instance, his refusal to go to his grandparents’ place, his dropping grades and his tendency of getting into more fights were all signs. However, his parents did not realise the changes were a result of something traumatic.
Apart from these emotional indicators, parents can also look out for physical signs, such as genital injuries, physical marks and inexplicable urinary tract infections.
According to Sheila, if these indicators were to be qualified on what they call the ‘Index of Suspicion’, the highest on that scale is the child’s own disclosure, followed by the physical and medical indicators (like genital injuries), and emotional and behavioural indicators. “The latter come lower on the Index as it could also be a result of bullying, learning difficulties or life changes,” she adds.
Apart from believing them, it’s crucial that caregivers make the child understand that the abuse was not her/his fault. “Reassure that they did the right thing by disclosing, and have a plan to ensure their safety and prevent future abuse,” says Dr Divya.
Caregivers should then explain to the child the need to see a doctor for a checkup, along with much reassurance that whatever health issues arise, the child will be assisted and supported. “Rushing to a hospital without preparing the child for medical procedures can be stressful for him/her,” Sheila says. Adolescents for instance, may be terrified of what might be found, like a pregnancy.
Then, reach out to a mental health professional, who could suggest ways for the family to deal with the child at home. They can then discuss with the child and family, and help with reporting the crime, as it is mandatory under section 19 of Protection of Children from Sexual Offences (POCSO) Act.
Sheila points out that there is a fine line between helping the child process the trauma, and overly focusing on it. “Measures like discontinuing school, not allowing for play time, discontinuation of regular activities, becoming overprotective, and creating a melancholic environment at home won’t be helpful for the child. Restoring normalcy - without dismissal i.e. along with validation of the child’s difficult experiences - is key to minimising the trauma.”
Unlike in a minor’s case, if the disclosure of CSA is made by an adult survivor, the medico-legal issues may not be relevant as significant time would have elapsed since the abuse experience. But the survivor still requires the emotional support and validation, says Sheila.
“Caregivers should ask the survivor what position they wish to take against the abuser, especially if it is someone known. The response can also include some kind of enquiry. Ask the survivor if there was any reason they did not disclose the abuse when it was happening… Perhaps even offer an apology, admitting not being there for them, then,” she adds.
While there are several accounts of how failure to acknowledge CSA affects survivors, there are a few stories of hope, of what the right intervention and support can mean for survivors.
It was only five years ago that 30-year-old Manish* disclosed the sexual abuse by a family member, and a male domestic help when he was a child.
“They were shocked and could not believe it; not because they did not believe in me, but it was disbelief that their child was abused. They were filled with guilt, regret and remorse,” he says.
It was not an overnight conversation. “We had conversations about it from time to time; we still do. My mother, who asked me the name of the abusers, was angry that someone had hurt her son. I did not disclose the names but the fact that she asked me, made a lot of difference and knew that I have her in my corner. My father, too, said he would have ensured the perpetrator was punished if he had the slightest inclination of the abuse. Their response was a coping mechanism for me. They also helped me get in touch with a good therapist,” adds Manish.
However, child sexual abuse cannot just be dealt by reacting the right way. As Shubham points out, “Adults need to take responsibility not just in terms of active action when the abuse is disclosed, but also in preventive capacity; even within their families, though it may be difficult.”
(*Names changed to protect identity)